K’gari-Fraser Island, the world's largest barrier sand island, is at the crossroads of World Heritage status, due to destructive environmental use in concert with climate change. Will K’gari-Fraser Island exemplify innovative, adaptive management or become just another degraded recreational facility? We synthesize the likely impact of human pressures and predicted consequences on the values of this island. World-renown natural beauty and ongoing biological and geological processes in coastal, wetland, heathland and rainforest environments, all contribute to its World Heritage status. The impact of hundreds of thousands of annual visitors is increasing on the island's biodiversity, cultural connections, ecological functions and environmental values. Maintaining World Heritage values will necessitate the re-framing of values to integrate socioeconomic factors in management and reduce extractive forms of tourism. Environmentally sound, systematic conservation planning that achieves social equity is urgently needed to rectify historical mistakes and update current management practices. Characterizing and sustaining biological refugia will be important to retain biodiversity in areas that are less visited. The development of a coherent approach to interpretation concerning history, access and values is required to encourage a more sympathetic use of this World Heritage environment. Alternatively, ongoing attrition of the islands values by increased levels of destructive use is inevitable.